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Title: | High end-of-treatment hepatitis B core-related antigen levels predict hepatitis flare after stopping nucleot(s)ide analogue therapy. | Austin Authors: | Hume, Simon J;Wong, Danny K;Yuen, Man-Fung;Jackson, Kathy;Bonanzinga, Sara;Vogrin, Sara;Hall, Samuel A L;Burns, Gareth S;Desmond, Paul V;Sundararajan, Vijaya;Ratnam, Dilip;Levy, Miriam T;Lubel, John S;Nicoll, Amanda J;Strasser, Simone I;Sievert, William;Ngu, Meng C;Sinclair, Marie ;Meredith, Christopher;Matthews, Gail;Revill, Peter A;Littlejohn, Margaret;Bowden, Scott;Visvanathan, Kumar;Holmes, Jacinta A;Thompson, Alexander J | Affiliation: | St Vincent's Hospital Melbourne, Fitrozy, Victoria, Australia.;Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.;Victorian Infectious Diseases Reference Laboratory, Department of Infectious Diseases, Royal Melbourne Hospital, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia. Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China. Victorian Infectious Diseases Reference Laboratory, Department of Infectious Diseases, Royal Melbourne Hospital, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia. Department of Medicine, University of Melbourne, Parkville, Victoria, Australia. Western Health, Melbourne, Australia. St Vincent's Hospital Melbourne, Fitrozy, Victoria, Australia.;Department of Medicine, University of Melbourne, Parkville, Victoria, Australia. Monash Health, Melbourne, Victoria, Australia. Liverpool Hospital, Sydney, New South Wales, Australia. Alfred Health, Melbourne, Victoria, Australia. Eastern Health, Melbourne, Victoria, Australia. Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. Monash Health, Melbourne, Victoria, Australia. Concord Hospital, Sydney, New South Wales, Australia. Austin Health Bankstown-Lindcombe Hospital, Sydney, New South Wales, Australia. St Vincent's Hospital Sydney, Sydney, New South Wales, Australia. The Peter Doherty Institute Victorian Infectious Diseases Reference Laboratory, Department of Infectious Diseases, Royal Melbourne Hospital, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia. |
Issue Date: | Oct-2024 | Date: | 2024 | Publication information: | Liver International : Official Journal of the International Association for the Study of the Liver 2024-10; 44(10) | Abstract: | Accurate biomarkers to predict outcomes following discontinuation of nucleos(t)ide analogue (NA) therapy are needed. We evaluated serum hepatitis B core-related antigen (HBcrAg) level as a biomarker for predicting outcomes after NA discontinuation. Patients with HBeAg-negative chronic hepatitis B (CHB) without cirrhosis were enrolled in a prospective trial evaluating clinical outcomes until 96 weeks after NA discontinuation. End of treatment (EOT) and off-treatment levels of serum HBcrAg, HBsAg, HBV RNA and HBV DNA were used to predict key clinical outcomes including hepatitis flare (ALT ≥5 × ULN and HBV DNA > 2000 IU/mL). The SCALE-B score was calculated for the purposes of model validation. HBcrAg was tested amongst 65 participants. The median age was 54 years, 54% were male and 83% were Asian. HBcrAg was detectable in 86% patients. HBcrAg level ≥4 log U/mL at EOT was predictive of hepatitis flare [8/10 (80%) vs. 17/55 (31%), p = .001]. The presence of either HBcrAg ≥4 log U/mL or detectable HBV RNA at EOT predicted for both biochemical relapse and hepatitis flare. The SCALE-B model at EOT predicted for virological relapse, biochemical relapse, hepatitis flare and HBsAg loss in this cohort. An increase in the serum HBcrAg level off-treatment was also associated with hepatitis flare. No participant with EOT HBcrAg level ≥4 log U/mL achieved HBsAg loss. High levels of serum HBcrAg predict for hepatitis flare after stopping NA therapy and low likelihood of HBsAg loss at week 96. People with high levels of serum HBcrAg are not suitable candidates for NA discontinuation. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/35429 | DOI: | 10.1111/liv.16029 | ORCID: | 0009-0002-0435-6138 0000-0001-7985-7725 0000-0001-6374-1525 0000-0003-0657-3048 |
Journal: | Liver International : Official Journal of the International Association for the Study of the Liver | PubMed URL: | 39007640 | ISSN: | 1478-3231 | Type: | Journal Article | Subjects: | biomarker hepatitis B hepatitis B core‐related antigen hepatitis flare nucleot(s)ide analogue nucleot(s)ide analogue discontinuation |
Appears in Collections: | Journal articles |
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